Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Leroy Snyder, PA

Individual provider Physician Assistant · NPI 1508595729

Ethan Leroy Snyder, PA is a Physician Assistant in Upland, California. Qualified in 2023, 3 years ago. Practices with Pacific Dermatology Institute, a 32-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

585 N Mountain Ave Ste A
Upland, CA 91786-8516
Phone: (909) 608-7546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA63622 (CA)

Record details

NPI number1508595729
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 6, 2022
Last updated in NPPESJanuary 6, 2024
Certification dateJanuary 6, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Pacific Dermatology Institute — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Other providers in Upland